Prednisone Improves Renal Function and Proteinuria in Human Immunodeficiency Virus-associated Nephropathy

To determine if prednisone ameliorates the course of human immunodeficiency virus-associated nephropathy (HIV-AN). Patients and Methods: Twenty consecutive HIV-infected adults with biopsy-proven HIV-AN (n = 17) or clinical characteristics of HIV-AN (n = 3) with serum creatinine concentrations >177 μmol/L (2 mg/dL) or proteinuria >2.0 g/d or both were prospectively evaluated and treated with prednisone at a dose of 60 mg/d for 2 to 11 weeks, followed by a tapering course of prednisone over a 2- to 26-week period. Serum creatinine concentration, 24-hour protein excretion, serum albumin, and steroidrelated adverse effects were assessed before and after treatment. Nineteen patients had serum creatinine concentrations >177 μmol/L (2 mg/ dL). Two of them progressed to end stage renal disease (ESRD) in 4 to 5 weeks. In 17 patients serum creatinine levels decreased from 717 ±103 μmol/L (8.1 ± 1.2 mg/dL) (mean ± SE) to 262 ± 31 μmol/L (3.0 ± 0.4 mg/dL) ( P